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Wellmark Blue Cross Blue Shield Senior Actuary in Des Moines, Iowa

Job Summary

Use Your Strengths as a Senior Actuary at Wellmark!

As Senior Actuary, you will be responsible for directing and managing the financial integrity of one or more market segments. You will recommend profitability targets and ensure pricing is consistent with established targets for those market segments. Direct the development for rating programs by providing information relating to regulations and rules, and consulting on a variety of issues related to rating of specific groups or benefits. Consult with and provide dependable, accurate and timely information to business stakeholders on various issues related to ratings for specific groups or benefits, such as rating factors and formulas. As well as perform peer review, including reviewing data, formulas, and calculation, as well as sign off and certify that work is in accordance with standard actuarial principles and is in accordance with any regulatory guidelines.

Ideal candidates will have at least five years of health insurance actuarial experience. You enjoy problem solving, are skilled at explaining complex information in layman’s terms, and they’re naturally inquisitive. You value stakeholder relationships and have a demonstrated history of serving as a trusted business partner and effective consultant.

Qualifications

Required:

  • Bachelor's Degree in Actuarial Science or related field, or direct and applicable work experience

  • Fellow of the Society of Actuaries (FSA)

  • Minimum 5 years of experience in an actuarial role within health insurance. Additional experience, exams or graduate level coursework may be considered in meeting the requirements

  • Thorough knowledge of at least one computer language, such as R, SAS or SQL

  • Advanced leading subject matter expert in two or more of pricing, reserving, or predictive modeling or other technical actuarial area: catastrophe model, economic capital model or assumed reinsurance

  • Proven ability to organize and analyze data, develop predictive models to drive business decisions, interpret the model results, turn data into actionable insights, and effectively communicate model results

  • Ability to identify creative, innovative solutions that help support and achieve long-range strategic goals

  • Advanced verbal and written communication and presentation skills, with the ability to effectively communicate and present information to varying audiences, including senior leadership

  • Strong consultation and interpersonal skills with the ability to build collaborative relationships across the business to produce results

  • Ability to independently manage complex projects, make decisions, and produce results in a deadline driven, fast-paced environment

  • Proven ability to understanding of applicable rules and regulations

  • Ability to coach and mentor others. Ability to effectively lead a team

  • Proficiency with Microsoft Office Suite and technical aptitude to learn new systems quickly and produce ad hoc reports. Advanced knowledge of Excel, PowerPoint and Word

Preferred:

  • Bachelor's Degree in Actuarial Science or a related field

JOB ACCOUNTABILITIES

a. Responsible for financial integrity of one or more market segments. Recommend profitability targets ensure pricing is consistent with established targets for those business segments priced in actuarial. Provide effective technical and nontechnical business advice with supporting documentation and analysis.b. Oversee and direct the development for rating programs by providing information relating to regulations and rules, and consulting on a variety of issues related to rating of specific groups or benefits.Consult with and provide dependable, accurate and timely information to business stakeholders on various issues related to ratings for specific groups or benefits, such as rating factors and formulas.c. Initiate comprehensive and timely data analysis of health care trends and financial measures with summary conclusions. Collaborate and partner with Business Analytics staff regarding data analysis for assigned work.d. Maintain, forecast, and provide oversight for needed rate increases by assigned market segments. Use data collection and research methodologies that meet established actuarial guidelines for statistical accuracy and that will produce reasonable results.e. Perform peer review activities including reviewing data, formulas and calculations as needed to validate work products completed by others. Reviewer should also be able to sign off and certify that work is in accordance with standard actuarial principles and is in accordance with any regulatory guidelines.f. Mentor staff and create a work environment that promotes the continual improvement of data capabilities and the quality of department analysis and reporting. Direct the work of Actuarial Analysts.g. Calculate adequate unpaid claims liabilities and oversee the work of others Provide information as needed for financial reporting reserves, annual statement exhibits. Recommend reserves for blocks of business and in total. Develop financial plans, reforecasts and other financial projections.h. Responsible for understanding legislation, rules and regulations which may significantly impact the actuarial, benefit experience and payment part of our business.Provide technical input on changes to existing and new regulation rules including recommendations that contribute to toplevel decisionmaking regarding products, pricing, financial performance, distribution, regulatory compliance, and legislative issues. Interpret rating regulations.i. Take lead on consulting to various departments such as Rating & Underwriting, Healthcare Informatics, Network Management, Product Development, Provider Contracting, Corporate Communications, Financial Reporting, Compliance, and others as needed on various initiatives.j. Initiate, plan, and manage corporate or department actuarial projects relating to complex issues and trends, coordinating with several different disciplines and staff to improve the overall effectiveness of the organization. Work typically involves assessment, analysis, design, testing and implementation of new systems, policies, or standards that are critical to the competitive positioning or longterm viability of the organization.k. Review, prepare and maintain documentation related to standard operating procedures as well as routine and special projects.l. Serve as a subject matter expert in corporate or departmental process improvement initiatives that involve designing, adjusting, and documenting work processes workflow to ensure that predictable and replicable success is achieved through best practice. Adopt a whole system view in evaluating and improving the sequence and content of work activities to optimize process effectiveness and integrity.m. Provide benefit cost information for various legislative initiatives. Provide technical input on changes to new and existing regulations and rules. Interpret how regulatory and legislative changes may affect business and develop impact analyses.n. Provide dependable, accurate, and timely forecasts and budgets for revenue and benefits.o. Other duties as assigned.

LocationUS-IA-Des Moines

Job ID 214783

Category Actuarial

Requires Non-Compete? No

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